INTRODUCTIONTo address concerns about reduced opportunities for operative training, a programme of training operating lists for senior house officers was established. The entire patient pathway was used as a learning resource so that training was offered in a range of areas including development of knowledge, communication skills and attitudes as well as operative technique.PATIENTS AND METHODS The programme was evaluated using a stakeholder approach, considering the impact on patients, the trainees and the host institution, including costs. Forty-two operations were performed during the 6-month evaluation period and the patients were compared with control patients undergoing the same procedure during a consultant-run operating list within 4 weeks.RESULTS There was no difference in the patients' experience or overall satisfaction when comparing the trainees' patients with controls. Senior house officers performed only six other supervised operations on routine lists during the period; the programme increased their experience by 700%. Costs were increased by 12% per patient.CONCLUSIONS There is an imperative to find new, efficient ways to train surgeons. Dedicated training operating lists with an appropriately controlled case-mix can both address a service need and provide a high intensity learning experience.

Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.

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